Weight loss common in treated Cushing’s syndrome patients: Study
Nearly half of those in disease remission lose at least 5% of total body weight
People with Cushing’s syndrome commonly lose weight after the disorder is treated, a new study found.
Findings indicate that nearly half of Cushing’s patients who achieve disease remission lose at least 5% of their total body weight in the years following treatment, and nearly a third lose 10% or more of their total body weight. Data suggest weight loss is more likely for patients who are female and/or obese.
“This study highlights the potential for substantial weight loss … in patients with [Cushing’s syndrome] who achieved remission following treatment, with nearly half of the cohort achieving clinically significant weight loss,” researchers wrote.
The study, “Weight gain reversibility and BMI following treatment for Cushing’s syndrome: long-term outcomes and potential predictors,” was published in Pituitary.
Patients’ body mass index also decreased on average
Cushing’s syndrome is a broad term that describes a group of conditions caused by abnormally high levels of the stress hormone cortisol. Cushing’s disease is a specific form of the syndrome where excess cortisol levels are driven by a tumor in the brain’s pituitary gland.
Weight gain is a common symptom of Cushing’s syndrome — people with Cushing’s tend to be heavier, with more body fat, than individuals without the disease.
Treatment for Cushing’s aims to normalize levels of cortisol; once cortisol levels are brought down, the disease is said to be in remission. In this study, scientists evaluated data from 308 people with Cushing’s syndrome to see how weight changes after the disease is brought into remission.
In addition to looking at total body weight, the researchers also looked at patients’ body mass index (BMI), which is a ratio of weight to height. BMI is measured in kilograms per square meter (kg/m2).
Over an average follow-up time of more than eight years after the first diagnosis of Cushing’s, patients with the disease tended to lose weight, with average weight decreasing from 85 kg (187 lbs) to 81.3 kg (179 lbs). BMI likewise decreased, from 31.2 kg/m2 to 29.9 kg/m2 on average. The decreases in weight and BMI were generally consistent across different types of Cushing’s syndrome, including Cushing’s disease.
By the end of follow-up, 44.5% of Cushing’s patients had lost at least 5% of their total initial body weight, and 29.2% had lost at least 10% of their initial body weight. The researchers also noted that the percentage of patients classified as obese (defined as a BMI of 30 kg/m2 or higher) decreased from 50.3% to 41.2% over the course of follow-up.
Female Cushing’s Syndrome patients more likely to experience weight loss
To put these data in context, the researchers compared the outcomes against findings from more than 1,000 people who did not have Cushing’s, but who were similar in terms of other factors including starting BMI. These individuals tended to gain weight over time: on average, total body weight increased from 81.8 kg (180 lbs) to 82.6 kg (182 lbs), while BMI increased from 30.7 kg/m2 to 31 kg/m2.
“A notable finding in our study is the contrast between the weight trends in the [Cushing’s group] and the control group over the follow-up period. While the patients with [Cushing’s syndrome] experienced both weight and BMI reductions, the control group showed a slight increase in weight and BMI, which aligns with typical age-related weight gain,” the researchers wrote. “This difference emphasizes the effectiveness of [Cushing’s syndrome] remission in reversing [high cortisol]-associated weight gain, as patients not only avoided further weight increase but also achieved a significant weight reduction.”
The scientists also conducted statistical analyses to look for factors that were strongly associated with a higher likelihood of significant weight loss (at least 5% of body weight) among people with Cushing’s syndrome. Data indicated female patients were nearly twice as likely to lose substantial weight after Cushing’s was brought into remission, and patients who were obese were about 34% more likely than those who were not to experience substantial weight loss following disease remission.
“To our knowledge, our study is the first to examine possible predicting factors for significant weight loss; we found that female gender and higher baseline BMI may be predictors of substantial weight reduction for patients with [Cushing’s syndrome] post treatment,” the researchers wrote.
The analyses also indicated that individuals whose BMI decreased by at least 1 kg/m2 in the year after being diagnosed were more than five times more likely to lose at least 5% of their body weight by the end of follow-up, suggesting early trends in weight loss are likely predictive of long-term outcomes.
Among the limitations of this study, the researchers noted they did not have data available about whether or how patients employed weight loss strategies such as dieting or exercise, which may have influenced these results.
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